Background: Cancer cachexia is a syndrome characterized by wasting of lean body mass and fat, resulting in decreased treatment tolerance and quality of life. Approximately 50% to 60% of patients with lung cancer develop cancer cachexia. Knowledge of cancer cachexia trends and outcomes in different types of lung cancers can help target patients most at risk of decreased survival. In this study, we examined weight loss trends in patients with lung cancer and survival according to cancer histology.
Methods: We conducted a chart review of patients diagnosed with lung cancer from 2007 to 2013 at a medical center in a large metropolitan area. Data collected included demographics, date of diagnosis, treatment received, type of cancer by histology, presence of metastasis, preexisting conditions, and other medications used. Body mass index and weight before, during, and after treatments were recorded, and percentage weight loss and survival days were calculated. Patients were also categorized according to the extent of weight loss (< 5%, 5%-10%, > 10%) through their disease course. Descriptive statistics, ANOVA, t tests, and regression analysis were used for data analysis to assess differences and relationships between percentage of weight loss and survival for all groups.
Results: Data from 197 patients were available for the study. All patients were males with an average age of 68 years; 55% of the patients were white and 35% were African American. Of the total patients, 47.7% had adenocarcinoma, 8.1% had small cell lung cancer (SCLC), and 44.2% had squamous cell cancer (SCC). Percentage weight loss trends for patients with adenocarcinoma showed a 9% loss from baseline till time of diagnosis and a total of 15% loss posttreatments. Patients with SCLC similarly showed a decline from 13% to 22%, and patients with SCC showed a 14% to 17% weight loss. Of the total patients with > 10% weight loss over time, 48% were patients with adenocarcinoma, compared with 10% of patients with SCLC, and 42% of patients with SCC. Average survival for patients with adenocarcinoma was 420 days, for patients with SCLC 321 days, and 492 days for patients with SCC. Weight loss percentage was significantly related to survival in all patients (r = -0.19, P < .01) and patient groups with adenocarcinoma (r = -0.25, P < .01) but not in patients with SCC or SCLC.
Conclusions: Cancer cachexia trends in patients with lung cancer are similar for patients with adenocarcinoma, SCLC, and SCC; however, the percentage of weight loss may adversely impact survival in patients with SCLC.
